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Before You Choose an EMR Vendor — Consider E-prescribing!

April 16, 2009
by By Michael Craige
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Calling all “Ambulatory Care Providers” that have not implemented an EMR, please evaluate e-prescribing vendors that offer e-prescribing as part of their complete EMR solution.
What's it about? Electronic prescribing (e-prescribing) involves the use of application software and connectivity tools that enable hospitals, physician offices and ambulatory clinics to create and send prescriptions electronically directly to pharmacy systems. Ambulatory care providers that have not implemented an EMR should evaluate e-prescribing vendors that offer this capability as part of a complete EMR system.

E-prescribing has been shown to reduce medication errors, improve efficiency and lower medication costs. As a result, there has been increasing interest on the part of healthcare insurers to promote the use of e-prescribing. Healthcare plans providing subsidized e-prescribing solutions to physician offices have emerged as competitors to traditional electronic medical record (EMR) healthcare IT providers, although more practices are moving to the full EMR solution. It’s apparent that the traditional EMR vendors will ultimately have to supplant the stand-alone products as they integrate with ambulatory patient records and better meet the workflow requirements of clinicians.

For all medical offices, e-prescribing will enables clinician productivity, operational efficiency, patient safety and patient/customer satisfaction. Integrating e-prescribing with your ambulatory patient record will should be an essential long-term strategy for your organization.
My advice To help reduce IT investment costs, clinical practices should adopt a tactical approach in which e-prescribing is the first application as part of your EMR system to be installed, with other applications added in a modular fashion over time.
Nice to have: The ideal situation and best-case scenario, is for a physician to access the patient complete record of care — which includes the patient medical history, current symptoms, diagnoses, treatment plans, test orders and results — when prescribing new medications and renewing existing ones.

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Comments

Thanks Robert.....they are many "Lesson Learn" and cost saving best practices that we can learn from when considering HIT/EMR adoption. I am sure you have some of your own. Here's a couple key best practices that I would like to share.....

1. Ensure stakeholder engagement at both the advisory and working group-levels, will provide valuable guidance towards mapping workflow for adoptions.

2. Also, take a step back and work to implement the full-function EMR solution through a series of complementary projects (this may not fit all facilities)
— Ensure each piece provides business value and fulfill business needs

3. And always develop a strong change management program to encourage early adoption and sustain use

4. Other key points here are - communication planning and materials, implementation planning and installation services, training materials and support, post-implementation evaluation and issue resolution should be in place no matter if its a full EMR or not

5. Also, they are a number of Physician Application Service Provider solutions that will provide the full ePrescribing or EMR solution without the full cost of ownership....(subscribe to ePrescribing through a secure Internet/Web GUI solution).

What's your though?

ePrescribing is a great way to start. I would advise caution to physicians who get a free ePrescribing program which then tends to lead them into purchasing a full package EHR from the same vendor. While ePrescribing is a highly efficient way to begin HIT in offices and hospitals with all of the benefits you mention, it doesn't necessarily answer the actual workflow needs and total EHR adoption challenges for many forms of medical practices. It does seem prudent that free or less expensive and proven systems make much more sense. I often wonder where common sense went when organizations make multimillion dollar investments, oops over-expenditures, on HIT when a smaller proven and perhaps open source solution seems so much more wise.

I totally agree, Michael. Nice post. In "Maslow's Hierarchy of Healthcare IT", ePrescribing is a proven, off-the-shelf, low-cost, low-risk first step towards an EHR. In our national strategy for EHR adoption, we are trying to jump from the Stone Age to the 1970s (jab intended) in one large step. ePrescribing is a no-brainer, easy, first smaller step that will provide physicians, payers, and patients with loads of value for quite some time... while the EHR vendor market shakes out with better products that will be able to integrate various ePrescribing "gadgets" into their modernized user interface.

Dale thanks for sharing. One step at a time never hurts. In our everyday practice as advisors, we work on a lot of system ion projects at Cimige Corp. (www.cimige.com). Vendor ions, contract negotiation, pre-planning implementation and clinician adoption services are some of what we do, and what we found is that most care providers that have not already implemented a solution are mostly jumping to an EMR without evaluating their e-prescribing need.

Cimige's methodology is one that engages our clients in a process which focuses initially on a clarification of organizational goals and objectives, includes an assessment of the effectiveness of the current organization, and then reviews the gap between HIT services and the organization's needs that was brought to us. From this process, we develops several major alternative strategies and then guides our clients leadership team in ing one clear overall strategic IT direction.

As I mentioned above, if e-prescribing can at any point enables clinician productivity, operational efficiency, patient safety and patient/customer satisfaction and that gap is identified, our interest will be to advise our clients of such.

Physician adoption has been the greatest barrier to the advancement of e-prescribing. However, new financial incentives today and mandated penalties by the government are showing an increase in use and that is strengthening the e-prescription infrastructure.

Wayne Craige

Chief Executive Officer & Bio-medical Informatician

Wayne Craige

@wayne_craige

www.cidrep.com

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